Robin L Fainsinger


Faculty of Medicine & Dentistry - Family Medicine Dept


Area of Study / Keywords


Dr. Robin Fainsinger graduated from the University of Cape Town in South Africa in 1981. He and his wife immigrated to Canada in 1985 and lived in rural Saskatchewan for a number of years, where Dr. Fainsinger worked as a Family Practitioner.

Dr. Fainsinger obtained the CCFP in 1990 and completed the first fellowship in palliative care medicine at the University of Alberta in the same year. Since then, he has worked with the Palliative Care Program at the Edmonton General Hospital and Grey Nuns Hospital. He was Director of the Palliative Care Program at the Royal Alexandra Hospital from October 1994 to April 2006. He is presently a Professor in the Division of Palliative Care Medicine, Department of Oncology at the University of Alberta. He was the Director for the Division of Palliative Care Medicine from 2000 to 2014. He is the Clinical Director for the Tertiary Palliative Care Unit at the Grey Huns Hospital, and the Section Chief for the Edmonton Zone Palliative Care Program. He is active in education and research, and has published articles on a number of palliative care topics, with an interest in dehydration, delirium and sedation at the end of life. His present research focus is on developing the Edmonton Classification System for Cancer Pain (ECS-CP). He has over 180 publications in journals and book chapters.


Cancer pain can be very complex, and may be treated using a combination of pharmacological and nonpharmacological approaches. Some types of cancer pain are more difficult to treat, and may require more complex management and more time before the pain is controlled. A classification or staging system for cancer pain would allow identification of patients that may require more complex management. Such a system would allow for improved assessment and management, as well as facilitating appropriate comparisons of clinical and research experience. Many research reports merely refer to pain as being due to cancer, or at best use a pathophysiological approach to differentiate cancer pain syndromes. The multi-dimensional aspects of cancer pain were included in an original classification system developed by Dr. E. Bruera. The Edmonton Staging System for Cancer Pain has a number of problems and was not widely used. Subsequent research has included construct validation, as well as a multi-centre Alberta inter-rater reliability and predictive value project, and a CIHR funded international multi-center predictive and reproducibility study. The now named Edmonton Classification System for Cancer Pain (ECS-CP) has been developed using a “TNM” model and the international study has been completed with several abstracts submitted or presented at national and international conferences, and a report has been published. A knowledge translation symposium sponsored by CIHR funding was held in 2010. One of the aims of the European Palliative Care Research Collaborative (EPCRC) was to develop a classification system for advanced cancer patients with pain, based on international consensus. In collaboration with our European partners who adopted the ECS-CP as the best starting point for evolution of an international classification system for cancer pain, we have been using this assessment in multisite international research. Research from this activity has been presented at international conferences and has also been published. The next phase of activity under the project title “Moving on – the next step in developing an international Classification System for Cancer Pain”, has been to incorporate new concepts into revisions of the ECS-CP which will be subjected to validation studies in local, national and international projects. A local pilot project of 300 patients in 3 Edmonton locations has been completed as well as analysis of results and local, national and international conference presentations, and a first publication. Work is underway on translations into French, Spanish and Catalan.      

Featured Publications

Smith N., Rajabali S., Hunter K.F., Chambers T., Fainsinger R., Wagg A.

3D Printing and Additive Manufacturing. 2020 December; 26 (8):432-442 10.12968/ijpn.2020.26.8.432

The Edmonton Classification System for Cancer Pain (ECS-CP): a pan-Canadian cross-sectional study comparing pain classification features across diverse specialist palliative care settings.

Palliative Medicine 2020, 34(15): 34. . 2020 September;